The diagnostic assessment and treatment and treatment planning in psychiatry is a dynamic process that integrates the biological, psychological, social, and behavioral paradigms to develop a plan of action that provides a rational for the types of interventions employed to sustain the therapeutic alliance and relieve suffering.

1. Psychodynamic Formulation
A Critical Tool For Managing The
Therapeutic Alliance

2. Defenses
 Mature Defenses  Borderline Defenses
 Suppression  Splitting
 Sublimation  Projective
 Reaction Formation Identification
 Idealization
 Devaluation
 Projection

3. Defenses
 Mature Defenses  Borderline Defenses
 Suppression  Splitting
 Sublimation  Projective
 Reaction Formation Identification
 Idealization
 Devaluation
 Projection

4. Defenses
 Denial
 Repression
 Projection
 Undoing
 Intellectualization
 Rationalization
 Externalization

5. Components of the
Psychodynamic Formulation
 1. Differential Diagnosis on Axis I
 2. Differential Diagnosis on Axis II
 3. Ego Function Assessment
 4. Adult Attachment Pattern
 5.Transference Predictions
 6. Counter-transference
 7. Transference Resistance
 8. Therapeutic Strategies and Tactics
 9. Prognostic Predictions

7. Attachment Patterns
 Ainsworth Attachment Patterns
 1. Secure
 2.Insecure
 3. Ambivalent
 4. Disorganized
 Adult Attachment Styles
 1.Secure
 2.Preoccupied
 3.Fearful Avoidant
 4.Dismissing

8. Ego Function Assessment
 1. Object Relations 8. Adaptive Regression in
 2. Affect Regulation the Service of the Ego
 9. Reality Testing
 3. Frustration Tolerance
 10. Sense of Reality
 4. Impulse Control  11. Stimulus Barrier
 5. Judgment  12. Synthetic Integrative
 6 Thinking Functions
 7. Defenses  13 Ego Autonomous
Functions ( Hard Wired)

9. Transference
 Positive  Negative
 Maternal or Paternal  Maternal or Paternal

10. Countertranference
 Positive  Negative
 Maternal  Maternal
 Paternal  Paternal
 Emerging from ones  Emerging from ones
own conflict own conflicts
 Emerging from  Emerging from
patient’s projections patient’s projections

11. Transference Resistance
 Focus on extra-transferential situations
and relationships in the here and now
 Focus on relationships in the there and
then

12. Therapeutic Strategy and
Tactics
Supportive Psychotherapy
Expressive-Insight Oriented Psychotherapy
Interpersonal Psychotherapy
Cognitive Behavioral Therapy
Dialectical Behavioral Therapy
Pharmacotherapy
Psycho-education Patient and Family Centered

13. Prognosis
 Outcome is determined by a GAS score
that seeks the highest level of
functioning in love work and play.
Factors complicating this goal involves
adherence, motivation, supports, pre-
morbid level of functioning etc. All
factor allow for a prognostic prediction